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U world journal > UWorld first pass > Flashcards

UWorld first pass Flashcards

1
Q

11B-hydroxylase deficency

A 
Female ambiguus genitelia
Hypertension 
HypoK
hyper NA
increased mineralocortocoids
decreased glucocorticoids
increased androgens
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2
Q

3 lead pacer placement

A

1- right atrium
2- right ventrical
2- AV groove (through the coronary sinus) to get to the left ventricle

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3
Q

3’ CCA tail

A

post transcriptional modification in eukaryotes (directly transcribed in prokaryotes)

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4
Q

74 - 93 nucleotides

A

tRNA

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5
Q

acute

A

Usually

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6
Q

Amatoxins affect?

Where do they come from?

A

RNA pol II which makes messenger RNA

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7
Q

beta blockers in hyperthyroid

A
  • Decrease sympathetic outflow

- Decrease the periferal conversion of T4-T3 by inhibiting iodothyronine deiodinase

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8
Q

Bioavailability

A

F/100 (IV is usually 100% bioavailability)


F= (areat under the oral curve x IV dose) /(area under IV curve x oral dose)

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9
Q

Cardiac output

A

CO=SV x HR

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10
Q

carnatine deficiency

A

Cannot shuttle fatty acids into the mitochondria and thuse B-oxydation cannot occur

Presentation: myopathy, weakness, myopathy, and hypoketoic hypoglycemia

synthasis of Acetoacetate is impaired

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11
Q

Cause of pulm edema in setting of aortic stenisos

A

Sudden decrease in left ventricular preload due to absent atrial kick caused by sudden afib

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12
Q

Central scomata

A

Scomata means darkness

macular leasions, demylination, diabetic retinopathoy, retinitic pigmentosa

macular degeneration can result of this with progressive loss of central vision because of lipid deposits in the macula

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13
Q

chronic

A

months to years

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14
Q

Class 1 A anti arrhythmics

A

Disopyramind, Quinidine, Procainamide (Double, Quarter Pounder)
Intermediate inhibition of phase 0 depolarization and prolonger effect of AP (QT) becayse of K+ channel block.

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15
Q

coronary arteriolar dialation

A

shunts blood away from ischemic tissue

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16
Q

Cryptococcal menigitis treatment

A

Amphotericin B

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17
Q

CSF in viral meningitis

A

Common microbes: enteroviurses

WBC: lymphocytes
Glucose: normal to mildly decreased

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18
Q

Damage to where causes hemiballism?

A

Subthalamic nucleus

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19
Q

Decrease calcium stones?


A

Potassium citurate. Citurate binds to ionized Ca2+

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20
Q

decreased binding to 2,3 BPG

A

Higher affinity of O2
HbF
Substitution of a lysine for a methionine causes familial erythrocytosis so the Hb doesn’t release O2 as well and have a decreased affinity for 2,3 BPG

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21
Q

Diphenoxylate

A

opiate anti-diarrheal that affects motility

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22
Q

dipyridamole

A

Coronary arteriolar dilation

shunts blood away from ischemic tissue

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23
Q

DNA pol I

A

remove RNA primers, 5’ exonuclease activity

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24
Q

dobutamine

A

B-adreneregic agonist with predominant B1 and min B2 and a1

Has a positive ionotrophic effect, weak posative chronotrophic effect

increases myocardial o2 consumption

**use in pts with MI complicated by cardiogenic shock

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25
Q

Dobutamine

A

Increase cardiac contractility

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26
Q

EBV causes proliferation of:


A

Activated CD8+ T-cells that react to CD21

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27
Q

Embryologic structures effects in DiGeorge

A 
3rd and 4th pharangeal pouches 
C-cleft palate 
A- abnormal facies
T- thymic aplasia 
C- cardiac abnormalities 
H- hypocalcemia (carpopedal spasms) 
22
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28
Q

external hemorrhoids

A

Painful
squamous epithelium
Innervated by branches of the pudendal nerve

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29
Q

Febrile seziure

A

treat with acetominophen

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30
Q

Fever, headache, myalagias, malase, cough, and core throat in school aged children

A

Influenza A

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31
Q

Findings of hyper aldosteroneism

A

hypokalemia
High BP
Hypernateremia

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32
Q

forign body infection

A

staph epideridis

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33
Q

gallstones during pregnancy

A

estrogen- cholesterol hyper secretion

progesterone- gallbladder hypomotility

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34
Q

germ tubes at 37 degrees

A

candidia albicans
budding yeast

most likely form of yeast with a central venous catheter

Pseudohyphae with blastoconidia

found in immunocompramised individules (HIV, TB)

T-lymphocytes prevent the superficial spread

neutrophils prevent hematoganous spread

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35
Q

Good pastures on Light microscopy

A

crecent formation==> rapidly progressive glomerular nephritis

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36
Q

Griseofulvin

A

P450 inducer

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37
Q

hartnup disease

A

defective intestinal and renal absorption of tryptophan

Tryptophan==> precurser for niacin and serotonin

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38
Q

Highly active antiretroviral therapy side effect

A

truncal fat redistribution
Lipodistrophy of the face subcutanious fat, extremities, and buttoks

primarly seen in patients taking stavudine and zidovudine

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39
Q

HIV patient wit brain mass with EBV genome

A

Primary CNS lymphoma

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40
Q

hydrochloric acid and alcohol after staining carbolfuchsin (aniline dye)

A

Acid fast stain

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41
Q

Hyperactue rejection

A

Min to hours

Preformed antibodies against graft

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42
Q

hypersensativity reactions

A

type I- immidiate, atopic

Type 2- cytotoxic antibody mediated

type 3- immune complex

Type 4- delayed type T cell mediated

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43
Q

Inhaled particals in the terminal bronchials are cleared mostly by:

A

ciliated cells

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44
Q

initial step in the pathogenisis of betathalassemia

A

mRNA mutation

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45
Q

internal hemorrhoids

A

columnar epithelium

innervation: inferior hypogastric plexus

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46
Q

isoproterenol

A

Non selective B adrenergic agonist

B1- increase cardiac contractility
B2- decrease systemic vascular resistance

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47
Q

Itraconazole and all azoles

A

CYP450 inhibitors

supress the synthasis of ergosterol

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48
Q

Lacuner strokes occur in the setting of?

A

HTN and DM

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49
Q

Layers to get to the bladder

A 
Skin 
Superficial fascia 
aponeurosis
Transversalis facia 
Bladder wall

**The bladder is extraperiteional and there for is not covered by peritoneum

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50
Q

Lactose intolerance

A

Lactase deficency

Galactosyl B-1,4-glucose ==> galactose is the step catalized by lactase

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51
Q

Medium containing vancomycin, colistin, nystatin, and trimethoprim

A 
Thayer-Martin medium

Vanco- inhibit gram +

colistin- inhibit gram -

Nustatin- inhibit yeast

Trimethprim- inhibit proteus species
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52
Q

Metanephric mesoderm:

A


Distal convoluted tubules come from the metanephric mesoderm

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53
Q

methotrexate

A

Inhibits Buhydropholate reductase in the synthasis of thymidylic acid and purines

Must suppliment with folinic acid

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54
Q

most anterior portion of the heart likelt injured in a penatrating trauma aiming posteriorly

A

RV

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55
Q

most frequent CNS tumor in immuno supressed patients

A

Primary CNS lymphoma caused by EBV virus

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56
Q

Myasthena gravis:


A

Diploplia, difficulty chewing, weakness and fatiguability of extraocular muscles that improves with edrophonium infusion
Type 2 hypersensitivity: antibody mediated/cytotoxic distruction

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57
Q

nests of polygonal C cells with congo red deposits in the setting of a pheo

A

MEN 2A or 2B 
RET proto-oncogene
 Medullary thyroid cancer with extracellular amyloid deposits

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58
Q

occlusion of the anterior cerebral artery

A

loss of sensory and motor function in the contralateral leg

bilateral==> behavioral problems

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59
Q

order of antibody genes

A

IgM==> IgD==> IgG==> IgE==> IgA

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60
Q

P450 inducers

A 
Phenytoin
barbituatates 
rifampin 
carbamazepine 
griseofulvin
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61
Q

P450 inhibitors

A 
ISN
cinemtidine
macrolids
azoles
grapefruit juice
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62
Q

Paget disease of the bone

A

Acceletated bone remodeling by osteoclasts

Excessive RANK and NF-kB activation

Bone pain, elevated ALK Phos in an elderly male patient

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63
Q

para-aminohippuric acid concentrations in the kidney

A

bowmens space

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64
Q

Phenytoin

A

P450 inducer

do not give with contraceptives

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65
Q

point mutation in sickle cell anemia

A

Valiene substilution for glutamic acid making the Hgl more sticky

sickle cell crises==> exertinal dympnea, PNA, abdominal and bone pain

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66
Q

PSGN

A

Hypercellular glomeruli
ASO antibodies
C3 deposits

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67
Q

pyruvate carboxylase

A

Cofactor: bioten
Action: pyruvate to OAA (1st step in gluconeogenisis

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68
Q

Pyruvate dehydroginase

A

Cofactor: thimine

Pyruvate ==> acetyl COA

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69
Q

Recurrent fever, dyspnia, and productive cough after an influenza A infection?

A

Staph aureus

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70
Q

relative erythrocytosis

A

dehydration
normal RBC mass
Polycythemia
***Pay attention to what meds the patients are started on

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71
Q

renal osteosystrophy

A

increased PTH
Increase Phosphate
increased Alk Phos
Decreased calcium

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72
Q

Right peri-chiasmial leasion

A

A. right nasal hemianopia

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73
Q

Right ventricular hypertrophy

A

Primary pulmonary hypertension, pulmonary stenosis

READ THE QUESTION

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74
Q

rightward extention of the ventricular PV loop

A

increased ventricular preload

NS infucion

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75
Q

second most common cause of ring enhansing leasions in HIV patients

A

Primary CNS lymphoma- a diffuse large cell non-hodgkin lymphoma
**Multiple leasions differentiates this from toxo

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76
Q

Serotoli cells

A

Secrete MIF

Lack of Serotoli: both male and female internal and just male external if child is XY

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77
Q

staph epidermidid virulance factor

A

Biofilms
coagulase - staph
extracellular pollysaccheride matrix
barrier to antibiotics

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78
Q

steps of inflammatory leukocyte accumulation

A

Margination: increased vascular leakage

Rolling: neutrophils roll on the endothelium binding to L-selectin on neutrophils or e/p- selectin on endothelial cells (cytokine stimulation)

Activation: actavated integrins injuce conformational change necessary for binding

Tight adheasion: neutrophils bind CD18 CD18 beta 2 integrins (Mac-1 and LFA-1), ICAM-1

Transmigration: Moving into the actual tissue requires PECAM01 found on peripheral ntercellular junctions of endothelial cells.

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79
Q

Symptoms of drug induced SLE:

A

-ANA and anti-histone antibodies present >95% of cases
-anti-dsDNA (rarely)

exposure to: Hydralazine, procainamide, Isoniazide, minocycline, quinidine

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80
Q

Telomerase

A

Human reverse transcriptase
Adds TTAGGG repeates
Active in stem cells
cancer cells upregulate there telomerase activity

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81
Q

Terbinsfine

A

Inhibition of squalene epoxidase

treatment of dermatophytosis

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82
Q

THF

A

single carbon group donor in the synthasis of purines and pyrimidines

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83
Q

Thimine cofactor

A

Pyruvate dehydroginase: pyruvate -> acetyl CoA

alpha ketogluterate dehydroginase

Transketolase- in the hexo monophosphate pathway

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84
Q

Thiopentinal

A

Lipid soluable IV anesthetic that is rapidly distributed to the brain and then redistributed to the muscle which decreases the plasma concentration

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85
Q

Time line after MI

A

0-4 hours: no visible change

4-12: wavy fibers with narrow elingated myocytes

12-24: myocytehyperesinophilia

1-3 days: coag necrosis, neutrophilic infiltrate

3-7 days: disintegration of dead neutrophils and myofibers, macrophage infiltration

7-10: formation of granulation tissue and phagocytoss of dead cells

10-14: granulation tissue with neovasc

2w-2m: scar formation

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86
Q

Top 3 cancers affecting women in order?


A

Breast> Lung (highest mortality) > colon (lowest mortality)

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87
Q

Toxoplasma gondii

A

Protozoin

Treatment: pyrmethamine and sulfadiazine with leucovorin(folinic acid)

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88
Q

Treatment for defective class switching?

A

IVIg

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89
Q

trichrome staining

A

giardia

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90
Q

Types of collagen and where they are found

A

1- dermis, bone, tendons, ligaments, dentin, cornea, blood vessels, scar tissue
2- cartilage, vitreous humor and nucleus pulposus
3- skin lungs, intestines, bone marrow, blood vessels, lymphatics and granulation tissue
4- basement membranes

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91
Q

Ulcer with central black eschar surrounded by edema

A

Bacillus anthracis- chains of gram + rods
live stock and bioterrosim

MEdusa head colinies on standard medium

produce an antiphagocytic d-glutamate capsule

can live at 100C

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92
Q

Uncontrolled diabetes in pregnancy

A 
Infant:
Flaccid lower extremities 
absent ankle reflexes 
poorly developed lumbar spine and sacrum 
Cuadal regression
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93
Q

unique componiant of mycobacterial cell walls

A

mycolic acid==> a waxy long chain fatty acid that is covalently bround to sugars within the cell wall
Nocardia and Mycobacterium

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94
Q

V wave on heart cath


A

Mitral regurge==> normal pressure should be 10mmHg during systole

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95
Q

vectorborne disease

A

mosquitos: malaria, dengue (brazil), chikunya
Ticks: lyne disease, RMSF

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96
Q

ventricular pacemaker in third degree block

A

AV node

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97
Q

what are the symptoms and lab finding of legionllosis?


A

High fever, relative bradycardia, confusion, headache, GI symptoms like wattery diarrhea, hyponaturemia, elevated transaminases. This is kind of an opportunistic infection

Sputum gram stain with many neutrifils with no organisms

Treatment: floroguinolones or newer macrolids

found in contaminated water

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98
Q

What are the symptoms of adenomyosis?

A

A: Heavy menstral bleeding due to increased endometral surface, uniformily enlarged uterus

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99
Q

What is Adenomyosis?


A

A Endometrial glandular tissue within the myometrium

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100
Q

What is the metyrapone stimulation test used for and what does it do?

A

Blocks 11-beta-hydroxylase and there for stimulates the secretion of ACTH. It is used to test the integraty of the HT-P-A axis.

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101
Q

What nerves pass through the jugular foramen?

A

CN IX, X, XI, Jugular vein

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102
Q

Which nerve is responsiable for syncope when tieing a tight tie?

A

Glossylpharengyl nerve when is located in the carotid sinus.

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103
Q

Hep B antigen on histology

A

finely granular homogeneous dull eosinophilic inclusions

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104
Q

Atresias of the jejunum/ilium

A

vascular injury in utero

gastroschisis

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105
Q

raggid red fibers on gomori trichrome

A

mitochondrial diseases

myoclonic epilipsy with raggid red fibers

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106
Q

pipercillin-tazobactam

A

Gram +, gram -, and anaerobic

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107
Q

prpp synthase

A

needed for purine and pyrimidine recycling

if not active the patient get gout

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108
Q

length constant in demylination

A

decreases

how far along an axon an electrical impulse can propagate

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109
Q

5th intercostal space

A

the lung is in front of the heart @ the midclavicular line

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110
Q

the spermatic cord passes through what

A

Deep inguinal ring==> transversalis facia==> superficial inguinal ring (external oblique muscle aponeurosis)

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111
Q

Selective immunoglobin deficency

A

failure of B-cells to switch from IgM to IgA

when transfused with blood can have anaphalactic reactions to small amout of IgA in transfused blood

commonly have otitis media

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112
Q

Cytokines

A

IL-1(Hot) = fever, recruit WBC
IL-2 (T)- secreted by T-cells, stimulated T cells
IL3(Bone)- growth of bone marrow stem cells
S
T
IL4 (E)- stimulates switch to IgE secreted by Th2 cells
IL5 (A)- bromotes differentiation of B-cells and class switching to IgA
IL6(k)- acute phase reactants like CRP

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113
Q

azithoprine

A

6MP metabolite
Broken down by xanthine oxidase and thiopurine methyltransferase
toxicity caused by allopurinol

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114
Q

Clozapine

A

atypical antipsychotic

AR: agranulocytosis, seziures, myocarditis, metabolic syndrome

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115
Q

tetrahydrobioten

A

BH4

Cofactor in the synthasis of seritonin, melanin, and catacholamines via phenylalanine and tryptophan

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116
Q

valproate in pregnancy

A

Neuraltube defects

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117
Q

surfactant

A

made by type 2 pneumocytes

decreases surface tension so that the smaller alvioli do not collapse because of high surface tension

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118
Q

right sided (complete) pure hemisensory loss

A

Thalamic stroke

VPL most likely

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119
Q

reactions catalized by 21 hydroxylase

A

progesterone to 11-deoxycorticosterone

17-OH progesterone to 11 deoxycortisol

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120
Q

A-fib drug with new heart block, hypotension, severe constapation

A

CCB (nondihydropyridine)

negative ionotropic effect
slow conduction velosity at AV node

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121
Q

mediator of gram - septic shoch

A

Lipid A in the Lipopolysaccharide capsule of gram - bacteria like e-coli

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122
Q

agar for diphtheriae

A

cyctine-tellurite agar (dark black

or loffelers medium

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123
Q

Polyol pathway

A

Glucose (aldose reductase) ==> sorbitol (sorbitol dehydroginase) ==> fructose

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124
Q

cause of diabetic retanopothy

A

sorbitol imbalance

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125
Q

what signifies irreversiable damage on histology after an MI

A

mitochondrial vacuolization and phospholipid containing amorphous densities

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126
Q

target of rabies

A

Acetylcholine receptors

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127
Q

MOA of tetrodotoxin

A

comes from puffer fish

binds to Na+ channels inhibiting Na+ influx and preventing action potential conduction

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128
Q

What degenerates in Wilson’s disease

A

Putamen

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129
Q

when to use MAOI like phenelzine tranylcypromine

A

In atypical depression with mood reactivity, rejection sensitivity, and increased sleep and apitite

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130
Q

what accumulates in alzheimers

A

neuronal amyloid precurser protein

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131
Q

Infections that cause reactive arthritis

A

chlamydia trach., salmonella, shigella, yersinia, campylobacter, clostridium difficile

Can also get conjunctivitis
HLA B27

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132
Q

Lecithin-sphingomyelin ratio is a marker for fetal lung maturity

what hormones control this

A

glucocorticoids (cortisol), prolactin, insulin, estrogens, andorgens, (t3-T4), catacolamines

cortisol has the greatest effect

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133
Q

symptoms of iron deficecy anemia

A

Spoon nails, fatigability, pallor, esophageal webs (plummer-vinson syndrome) which causes dysphagia

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134
Q

alanine transfers its amino group to ______ before becoming glucose

A

alpha-ketogluterate

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135
Q

Trendelenburg sign

A

Hip drop when the ipsalateral foot is off the ground

Damage to the contralateral superior gluteal nerve that arises from the L4-S1 ventral rami

Weakened contralateral gluetus medius

Injection to the superior medial part of the buttox

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136
Q

Nerve damaged in compartments syndrome involving the anterior compartment of the lag

A

Deep peroneal nerve

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137
Q

principle site of uric acid accumulation in the kidneys during tumor lysis syndrome

A

collecting ducts due to low pH (uric acid pKa=5.4)

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138
Q

For tumor lysis syndrome what also must be given to prevent kidney damage

A

allopurinol or colchasine

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139
Q

what precipitates hepatic encephalopathy in the setting of a GI bleed

A

Increased load of nitrogenous substances absorbed by the gut because there is blood being digested

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140
Q

Infections in burn patients

A

Gram + => staph or encerococcus

Gram - ==> pseudomonas, klesella, acinetobacter

Gram - on gram stain is pink

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141
Q

schizophreniform disorder

A

> 1 month

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142
Q

schizophrenia

A

at least 6 months of symptoms

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143
Q

schizoaffective disorder

A

concurrent mood episode, active phase symptoms or schizophrenia + at lease 2 week lifetime history for delusions or hallucinations in absence of prominant mood symptoms

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144
Q

t(15:17)

A

AML

With auer rods

APML with abnormal promylocytes with auerrods on the smear

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145
Q

t(8:14)

A

burkett lymphoma

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146
Q

t(9:22)

A

CML

BCR-ABL mutation

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147
Q

t(11:14)

A

Mantel cell lymphoma

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148
Q

Acute angle glaucoma

A

Treat with acetozolomide

Acts at the proximal convoluted tubule

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149
Q

HPV

A

Koilocyte on smear
immature squamous cell with dense irregularly staining cytoplasm
enlarged pyknotic nucleus
rasinoid appearance

Scant clear discharge

Skin warts: 1-4
Genital warts: 6,11
Cervical, vaginal, vilvar anal neoplasia: 16, 18

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150
Q

when is B-hCG detectable in the serum

A

8 days

14 days for pregnancy test at home

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151
Q

Northern blot

A

mRNA

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152
Q

Beta 2 on uterus

A

Relax uterus

Defer premature labor

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153
Q

Left shift for oxygen-hemoglobin dissociation curve

A
  1. Increased pH
  2. Decreased 2,3 BPG
  3. Decreased Temp (hypothermia)
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154
Q

Which amino acid is essential in patients with PKU

A

Tyrosine because there is no phenylalanine hydroxilase to convert phenylalanine to tyrosine

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155
Q

membranous nephropathy

A

IgG4 and PLA2R antibodies

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156
Q

Contralateral hemianopia with macular sparing

A

PCA territory infarction

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157
Q

Kerley B lines

A

short horizontal lines situated perpendicular to the pleural surface that represent eedema of the inerlobar septa

seen in pulmonary edema

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158
Q

Cheyne-stokes breathing

A

congestive heart failure

Granually increasing and decreasing tidal volumes until the next apnic period.

PCO2 drops below a threshold and then the pt goes apnic

Then when it goes above a certain level they breath really fast

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159
Q

Invasive aspergillus

A

In immunosupressed patients that have hyphe at acute angles and septe

treatment for leukemia is a strong risk factor for fungal sinusitus

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160
Q

MOA for nitroglycerin

A

Actavates guanalate cyclase and promotes the conversion of GTP to cGMP==> increased cGMP lead to decrease Ca2+ resulting in decreased activity of myosin light chain kinase and finally dephosphorolation of myosin

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161
Q

Daptomycin

A

MOA: depolarized cellular membran by creating transmembrane channels

AR: myopathy & CPK elevation

note: inactivated by pulmonary surfactant so it cannot be used for PNA

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162
Q

different SpO2 between RA and RV

A

VSD

Holosystolic murmur at left sternal boarder

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163
Q

embryologic cause of tetrology of fallot

A

Deviation of the interventricular septum

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164
Q

Pyruvate kinase

A

PEP to pyruvate

needed to make lactose in RBC
results in helolysis and increased work for the spleen

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165
Q

NF-1

A

Chromosome 17

NF-1 gene

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166
Q

oseltamivir

A

prevents virion release

neuroamidase inhibitor
Effective in Influenza A & B

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167
Q

Main amino acid in collagen

A

Glycine

GLY-X-Y
many of the other amino acids are proline which makes kinks

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168
Q

Mycophenolate and tacrolimus

A

immunosuppressant drugs used post transplantation

Hypercellular glomeruli

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169
Q

filtration fraction

A

FF=GFR/RPF

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170
Q

Lowest osmolarity in nephron

A

DCT
Around 100

Highest in Loop of henley

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171
Q

Lymph from the testies

A

Para-aortic lymph nodes

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172
Q

Superficial inguinal lymph nodes

A

cutanious lymph from the umbilicus down including external genitetelia

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173
Q

Small blueish greyish specks on the buccal mucosa with high fever and nasal discharge

lack of vaccinations

A

Koplik spots

caused by the measals virus
CCCK: Cough, coryza, conjunctivitis, koplik spots

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174
Q

Role of eosinophils in paracytic defense

A

Antibody-dependent cell-mediated cytotoxicity

Type 1 hyper-sensitivity

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175
Q

fungus found in soil, bird feces, and bat feces

A

Histoplasma capsulatum
dimorphic fungus
immune response closely resembles TB (hilar lymphadenopathy)

Specimins show ovoid cells with macrophages

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176
Q

Serotoli cells

A

Secrete inhibin in response to FSH

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177
Q

New odynophagia in the setting of GERD

A

Ulceration

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178
Q

Fractionated Heprin target

A

Xa

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179
Q

In the sarcomere

Actin connects to:

Myosin connects to:

A

Actin: Z line

Myosin: M line

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180
Q

HLA-B*57:01

A

Abacavir hypersensativity

Nucleoside reverse transcriptase inhibitor

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181
Q

ventricular contraction rate in patient with A-fib

A

AV node refractory period

90-170 BPM

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182
Q

change of bruise from blue to green

A

Heme oxygenase

Decreaseds heme to biliverdin, CO, and ferric iron

Biliverdin is green

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183
Q

PI3K/Akt(protein kinase B) /mTOR pathway

A

growth factor pathway

Causes translocation to the nucleus and gene transcription

Over active in many cancers

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184
Q

Isotretinoin

A

Accutane

All trans retanoic acid analog

Get a pregnancy test

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185
Q

Urea cycle

A

Add picture

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186
Q

effect of ureteral constriction or obstruction on GFR and Filtration fraction

A

decreases both

FF increases transiantly but decreases because of effarent arterole constriction due to decreased GFR

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187
Q

presentation of patient with somatostatinoma

A

Hyperglycemia, cholelithisis, statorrhea

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188
Q

in what setting does dystrophic calcification occur

A

Cellular necrosis in the setting of normal calcium levels

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189
Q

predisposition for pylonephritis

A

Vesicoureteral reflux **most likely cause

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190
Q

Oval round yeasts within macrophages

A

Histoplasma capsulatum
survive in macrophages

Hilar lymphadenopathy, oral ulcers, hepatosplenomegaly

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191
Q

Serpentine formation

A

Virulance factor for TB

Foul smelling sputum

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192
Q

Clindamycin

A

Binds to the 50S ribosomal subunit
Pneumonia for alcoholics

Acts against aerobic gram + and anaerobic organisms

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193
Q

Rifampin

A

Inhibition of DNA-dependent RNA polymerase

SE: GI side effects, red-orange body fluid, cytopenia

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194
Q

Cholecyctectomy absorb most of their diatery fats where?

A

Jejunem

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195
Q

unilateral fetal hydronephrosis

A

obstruction at uteropelvic junction

Last segment of the fetal ureter to calalize

metanephros produces urine 8-10 weeks into pregnancy

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196
Q

first area damaged during global ischemia

A

hippocampus

pyramidal cells of the hippocampus and neocortex and the perkinje cells of the cerebellum

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197
Q

Rash with strep throat

A

Scarlet fever

Caused by Group A strep

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198
Q

primary polydipsia

A

Hyponatriemia (would be hypernatremia in central or nephrogenic DI with a low serum osmolality

Treat with water restriction

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199
Q

Symptoms of HSV-1 in children

A

Fever, visiculoulcerative gingivostomatitis (very painful leasions in the mounth and swollen gums) and cervical lymphadenopathy

DS DNA virus

Tzanck preperation

Multinucleiated giant cells with intracellular inclusions

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200
Q

Buspiron

A

partial antagonist of the 5HTA receptor

Slow onset
Does not work for acute anxiety

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201
Q

when is GTP made in the TCA cycle

A

When Succinyl-coA is converted to Succinate

used as a cofactor for phosphoenolpyruvate decarboxykinase

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202
Q

Brachieocephalic veins feed into what?

how many are there?

A

There are two so blocking of just one can cause unillateral back up

The feed into the SVC

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203
Q

Sudden withdrawel of gluccocorticoids

A

decreased CRH
Decreased ACTH
Decreased Cortisol

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204
Q

sudden upward jerking of the arm at the shoulder can cause injury to what?

A

Lower trunk of the brachial plexus

Fibers of C8 and T1

Total claw hand deformity
paralysis of intrensic hand muscles

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205
Q

Narcolepsy

A

-lapses into sleep or naps (3x per week for 3 months)

Cataplexy: brief loss of muscle tone precipitate by strong emotion
-low levels of hypocretin -1 in CSF

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206
Q

hormone that prevents lactation during pregnancy

A

Progesterone made by the placenta

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207
Q

histology of acute hepatitis

A

Spotty necrosis with balooning degeneration, counsilmen bodies and mononuclear cell infiltrates

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208
Q

presentation of viral hepatits

A

fever, malase, annorexia

signs of cholestasis: jaundice, pruitis, dark-colored urine, and acholic stool

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209
Q

most common ligament involved in ankle sprains

A

anterior talofibular ligament

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210
Q

failure to metabolise ceramide trihexoside

A

Fabray

Deficent in a-glactosidase A

XR

Angiokeratomas, cv, peripheral neuropathy, and kidney failure

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211
Q

Gram + rod with a very narrow zone of beta-hemolysis on blood agar

A

Listeria monocytogenes

Tumbling motility at 22C
Intracellular

Listereolisin-O- pore forming toxin that kills phagosomes

neonates prone to meningitis because there cell mediated immunity is not yet matures.

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212
Q

part of lung effected in chronic rejection after transplant

A

Small airways becaome inflammed

with renal transplants it is vascular obliteration

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213
Q

hypertrophy of which cells with renal artery stenosis

A

Modified smooth muscle cells of the afferant arterial

JG cells
The sense sodium and electrolite content

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214
Q

target of cephlosporins

A

Transpeptidases

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215
Q

glanzmann thrombasthenia

A

AR
Deficent or defective GP IIb/IIIa which normally binds fibrinagen

There is no platelet clumping

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216
Q

target of Abciximab

A

GP IIb/IIIa

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217
Q

target of clopidigril

A

P2Y12 on platelet ADP receptors

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218
Q

inharitance pattern of G6PD

A

X-linked recessive

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219
Q

hepatitis B infection in infants

A

Usually contracted during birth

If HBeAg posative then there is a High risk (90%) of chronic infection
High viral replication rate
mild elevation of LFT

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220
Q

What secretes intrensic factor

A

Paritial cells

They are in the upper glandular layer of the stomach

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221
Q

IL-12

A

Stimulate differentiation into Th1 cells
this means no IFN-gamma is made to activate macrophages which are necessary to mediate intracellular organisms like mycobacteria

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222
Q

enzyme needed for F6P to ribose

A

Transketolase

**G6PD is necessary for making NADPH

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223
Q

High potency first generation antipsychotics

A

Trifluoperazine
Fluphenazine
Haloperidol

EPS side effects
Parkensoniansim
Dystonic

(Try to Fly High)

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224
Q

Low potenticy first generation antipsychotics

A

Chlorpromazine
Thioridazine

SE: anticholenergic, antihistimine, sediation, alpha 1 blocade

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225
Q

Nerve responsiable for planter flexion and sensory innervation of plantar portion of foot

A

Posterior tibial nerve

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226
Q

Serum PTH, Ca2+, and phos in primary osteoperosis

A

Normal

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227
Q

treatment for hereditary orotic aciduria

A

Uridine supplimentation to bypass the enzymatic defect ( a defect in uridine 5’- monophosphate synthase

no hyperammoniemia
Autosomal recessive

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228
Q

gram + cocci in chains that cause UTI after procedure

A

Enterococcus

Gamma hemolysis on blood agar (no hemolysis)
PYR posative
grow in bile and 6.5 sodium chloride

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229
Q

Target of c-diff toxins

A

Rho-regulatory proteins involved in maintaining cytoskeletal structure

Disruption of cellular tight junctions

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230
Q

erythema infectosum

A

malase, coryza, headache and fever followed by a rash on the cheeks that feels burning hot

Cause by parvo-virus 19
non- enveloped SS DNA virus
Replicates in erythrocyte precursers in the bone marrow because of the presence of P-antigen

Transmitted respiratory, food, and transplacentally

This is also known as fifth disease

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231
Q

capitation

A

an arrangment in which a payor pays a fixed predetermined fee to cover all of the medical services required by a patient

payment structure underlying the health maintance organization

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232
Q

Role of ATP in skeletal and cardiac muscle contraction

A

release the myosin head from its actin binding site and then energize a conformational change that resets the myosin head to contract again the next time it binds to actin

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233
Q

Carbamazepine

A

Epilepsy drug
used for trigeminal neuralgia (irriataion of the trigeminal nerve)

increases Na+ inactivation

also a mood stablizer

SE: Diplopia, ataxia, agranulocytosis, SIADH, Stevens-johnson syndrome

Cytochrome P-450 inducer

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234
Q

Vaginal bleeding, uterine preg with no fetal heart beat

Evacuated uterine contents containing felat tissue, edemitoud villi with focal trophoblastic proliferation, and some normal appearing villi

A

Partial hydactoform mole

overexpression of paternal genes

235
Q

Treatment for cyanide toxicity

A

Sodium thiosulfate

Provides sulfer for rhodanses to metabolize the cyanide and excrete it in the urine

also used:
Sodium thiosulfate and hydroxocobalamin

Note: Cyanide poisening presents with bright red venous blood

236
Q

Lambert-eaton syndrome

A

Paraneoplastic syndrome with autoantibodies against pre-synaptic calcium channels
movement improved with multiple stimulations

237
Q

Pathogenisis of spider angiomata

A

Hyperestrogenism

238
Q

cause of wrinkles

A

decreased collagen fibril production

239
Q

Substances involved in andiogenisis

A

Vascular endothelial growth factor (VEGF) ==> IL-1 and IFN-gamma can activate this pathway

Fibroblast growth factor

240
Q

Leukotriene B4

A

stimulated neutrophil migration to sites of inflammation

Other chemotactic agents:
5-HETE (leukotriene precursor), compliment component C5a, IL-8

241
Q

t(14:18)

A

Follicular cell lymphoma

Bcl-2 (c 18) onto Ig heavy chain locus( c 14)

242
Q

Ostercytes are connected by what

A

gap junctions

They negotiate bone stress

243
Q

acting out

A

expressing unacceptable feelings through actions

244
Q

Denial

A

behaving as if an aspect of reality does not exist

245
Q

displacement

A

transferring feelings to a more acceptible object

246
Q

intellectualization

A

using intillect to avoid uncomfortable feelings

247
Q

projection

A

attributing ones own feelings to others

248
Q

reaction formation

A

responding in a manner opposite to one’s actual feelings

249
Q

splitting

A

seeing others as all bad or all good

250
Q

ataxia-telangiectasia

A 
AR 
Cerebellar atrophy leads to ataxia 
Repeated sinopulmonary infections 
ataxia in the first years of life 
Ineffeciant DNA repair
251
Q

Embryologic origen of thyroid parafollicular cells

A

neural crest

252
Q

main side effects of TZD

A

fluid retention due to increased sodium retention

can cause decompensation of underlying congestive heart failure

Target: PPAR-gamma and RXR

**They have a very low risk of causing hypoglycemia because they increase insulin sensitivity instead of insulin secretion

253
Q

MOA of colchicine

A

Binds to tubulin and inhibits polymerization into microtubules

SE: Diarrhea and nausia

254
Q

transketolase

A

present in the cytosol and utilized in the pentose phosphate pathway
Uses thymine as a cofactor

255
Q

Activation of which pancriatic enzyme can cause acute pancreatitis

A

Tripsinogen to tripsen because that activated all of the other pancreatic enzymes

256
Q

Membranous nephropathy, flank pain, hematuria, right sided varicocele

A

renal vein thrombosis due to loss of anti thrombin III

257
Q

kind of incontanance in MS

A

urge incontanance

Overactivity of detruser due to a leasion that basically overrides the brains control of micturation

258
Q

Babesiosis

A

tick born infection

Splenectomy puts patients at an increased risk

Cross shaped intraerythrocytytic inclusions 
Thrombocytopenia 
hemolytic anemia 
respiratory distress 
found in conneticut 
ARDS, flu like symptoms

Icodes tick vector

259
Q

Cause of valley fever

A

Coccidioides immitis

Spheruoles packed with endospores

260
Q

Niacin side effects

A 
Gouty arthritis flare 
flushing
warmth
hepatotoxicity 
hyperglycemia for patients with diabetes
261
Q

Alendronate and risedronate

A

bisphosphonates
structurally similar to pyrophosphate and attach to hydroxyapatite binding sites in areas of increased bone turnover

can have stable or increased done density

262
Q

Agent used to short term treatment of insomnia

A

Zolpidem
structurally similar to benzos

  1. not as addictive
  2. no anticonvolsant activity
  3. no muscle relaxing properties
263
Q

mechinism of action of opiaits for pain control

A

increases K+ efflux out of cells causeing hyperpolerization of those cells

controlled by G-protein linked receptors

**Think of GIRK

264
Q

Fever, throat pain, dysphagia, ispiratory strider

immature hematopoietic stem cells on peripheral blood smear

A

T-ALL

Dysphagia and strider are indicitive of a medistinal mass

B-ALL would have hepatosplenomegaly and bone pain

common in young boys

265
Q

acute rejection

A

1 week after transplant

host T cells sensitized to graft MHC

Mononucular infiltrates

266
Q

Treatment for patient with hemofelia acutely

A

Thrombin because it bypasses the deficency in the intrensic pathway

(VIII or IX)

267
Q

Heteroplasmy

A

having different organillular genomes (mitochondria)

***explenation of different phenotypes

268
Q

comedocarcinoma

A

Ductal carcinoma in situ
has not invaded the basement membrane
Central necrosis with ducts
Micro calcification clusters

269
Q

what cannot use ketone bodies for fuel

A

Erythrocytes

270
Q

what does ADH injection do to the clearance of urea

A

it decreases it because it activates urea transporers in the medullary collecting duct

271
Q

Nesiritide

A

Recombinant form of BNP

272
Q

loss of sensation of lateral forearm

weakness lifting at elbow

A

C5-c7

musculocutanious nerve

273
Q

Premature infant with high pitched cry, prominant scalp veins, tense fontenels, blood in lateral ventrical on ultrasound

A

Germinal matrix hemorrhage

highly vascularized subventricular layers

274
Q

liver and lung dysfunction with acid-Shiff reaction and intracellular glanules

A

A1AT deficiency

intracellylar granules have unsecreted A1AT

275
Q

which receptors on beta cells decrease insulin secretion in the presence of epinepheran

A

Alpha 2
Somatostatin 2

so it these are blocked then insulin will increase when epi is administered

276
Q

pink colored mucoid colonies on MacConky agar

A

klebsiella pneumonae

277
Q

enzyme deficient in fructose intolerance

A

aldolase B

presents when the baby switches from breast milk to formula

hereditary fructose intolerance is AR

aldolase B is also needed for gluconeogenisis so the patient becomes hypoglycemic during times of fasting

278
Q

Ethambutol

A

TB drug
MOA: inhibition of arabinosyl

SE: optic neuropathy causing central scomata

279
Q

4 drug combo for TB

A

Rifampin: inhibition of bacterial DNA dependant RNA polymerase

ISN: inhibition of mycolic acid synthasis (give vit B6)

Pyrazinamide

Ethambutol: inhibition of arabinosyl

280
Q

Treatment for allergic asthma

A

Leukotriene D4 ANTAGonist because they can cause mucus hyper secretion and edema

Drugs: zafirlukast and montelukast

281
Q

Increased MMP and actin containing fibroblasts at the site of w would

A

contracture

282
Q

order of conduction velocity in the heart

A

fastest==> slowest

Perkenje system (ensures bottom up contraction of the ventricles) ==> atrial muscle==> ventricular muscle==> AV node (slowest to allow the ventricals to fully fill with blood during diastole)

Pneumonic==> Park At Venture Ave

283
Q

what is elevated in anaphylaxis

A

You measure tryptaase to support your diagnosis

anaphylaxis is a result of wide spread mast cell and basophil degranulation leading to an increase in inflammatory mediators, histamine, and tryptase

284
Q

what leads to basophil and eosinaphil degranulation

A

receptor cross linking and aggrigation of IgE on the surface of these cells

285
Q

Argatraban

A

direct thrombin inhibitor

Use for the treatment of HIT

286
Q

increased ornithine acid excretion and high ammonia levels

A

ornithine decarboxylase deficency

287
Q

fusobacterium and peptostreptococcus on culture of a lung leason

A

Indicative of a pulmonary abcess caused by these anarobes

Treatment: clindamysin

Think aspiration as a cause (ie. seziure disorder)

288
Q

An oocyte from the fallopian tube soon after ovulation would be in what stage of gametogenisis

A

Metaphase of meiosis II

289
Q

homonymous hemianopia

A

both eyes cant see the right or left visual field

optic tract leasion

290
Q

lipid stain after a cerebral infarct

A

microglea

have lipid dense cytoplasms at thi spoint because they are the macrophages of the brain and they are taking up a lot of mylen that was damaged

they infiltrate about 5 days after an infarct

neurons show irreversiable damage

macroscopic damage can be seen after 12 hours and hypodense areas can be seen after 1 week

291
Q

desired quality of drug for hepatic excretion

A

high volume of distribution

high lipid solubility

292
Q

Panic disorder

A

recurrent, unexpected panic attacks (can’t feel them coming on)

PANICS
Palpitations
Paresthesias 
Abd distress 
Intense fear of losing confrom for i month or more 
Chest pain/chills 
shaking
293
Q

social anxiety

A

anxiety restricted to social situations

294
Q

generalized anexity disorder

A

chronic multiple worries, anxiety, tension

295
Q

recombination

A

exchange of genes between 2 chromosomes by crossing over within regions of dignificant base sequance homology

296
Q

rituximab

A

used in non-hodgkin lymphoma

Targets CD-20

297
Q

Retroperitoneal abdominal organs

A 
Suprarenal glands
Aorta & IVC 
Duodenum (except first part) 
Pancreas (head and body) 
Ureters & bladder 
Colon 
Kidneys 
Esophagus 
Rectum
298
Q

kidney-bean shaped diplococci

A

meningococcal menigitis

Toxin: lipooligosaccharide

activates TNF-alpha, IL-1B , IL-6, IL-8

Waterhouse fredrechson syndrome with bilateral adrenal hemmorhages

299
Q

Patients with one or more lifetime manic episodes

A

Bipolar I disorder

300
Q

Hypomania with major depressive episodes

A

Bipolar II

301
Q

flutamide

A

competitive testosterone receptor inhibitor

use for bone pain in prostate metastasis

302
Q

BPH drugs that decrease the size of the prostate

A

5- alpha reductase inhibitors

eg. finasteride, duasteride

303
Q

alpha adrenergic antagonists for BPH

A

terazosin, tamsulosin

304
Q

non casiating grnulomas on colonic biopsy

A

CHRONE’S DISEASE
Transmural inflammation
skip leasions

305
Q

histologic changes in prion desease

A

spongiform transformation of grey matter

306
Q

c-jun

c-fas

A

DNA binding proteins that can be detected with the use of a south western blot

307
Q

dip after alveolar oxygenation

A

mixing with deoxygenated blood from small cardiac veins

308
Q

hurshprung disease

A

failure of neural crest cells to migrate to the rectum

309
Q

type I muscle fibers

A

Pastural support
High myoglobin, low glycogen, high amount of mitochondria

Ex. paraspinal muscles

310
Q

vaccienes composed of a polysaccheride attached to a protein capsule

A

strep pneumo
Neisseria meningitidis
H. Influenza

311
Q

potentcy

A

dose of drug that is required for the desired effect

the lower the E(50) the more potant the drug

312
Q

mucicarmine stain

A

cryptococcus neoformans

red stained round yeast cells

313
Q

Renal plasma flow calculation

A

PAH clearance=(urine [PAH]xurine flow rate)/plasma PAH

RBF=PAH clearance / (1-hematocrit)

314
Q

Blood supply of AV node in a patient with L dominant circulation

A

Left circumflex artery

315
Q

Ivabradine

A

blocks funny sodiu channels during phase 4. Only slows HR without effceting contractility

316
Q

risk with interscalene nerve blocks

A

ipsalateral diaphragmatic paralysis
C3-5 keep the diaphragm alive

used to paralize the brachial plexus

317
Q

causes of vit A deficency

A

Insufficient dietary intake

pancreatic insuffancy
cholestatic liver disease/liver obstruction==> generalized puritis and vit a deficency

intestinal malabsorption

318
Q

erythema marginatum

A

circular leasions with central clearing on the abdomen

seen in rheumatic fever

319
Q

persistant fever, brassy cough, difficulty breathing, stridor

A

Croup caused by paramyxovirus

can also see the steaple sign on X-ray `

320
Q

is the ID50 for shigella high or low

A

low

you need as little as 10 organisms to be infected

321
Q

Arsenic poisoning treatment

A

Dimercaprol increases urinary excretion of heavy meatles by forming stable, non-toxic soluable chelates

322
Q

Symptoms of arsnic poisening

A

GARLIC BREATH
vomiting/watery diarrhea, QT prolongation

Chronic: stocking glove neuropathy

it impares cellular respiration viz inhibition of pyruvate dehydroginase

323
Q

increased propionic acid in the blood

A

issues with metabolism of valiene, isoleucine, methionine, cholesterol, or odd chain fatty acids

due to a deficency of propinoyl CoA carboxylase

324
Q

stab wound just above the clavical

A

damages the lung pleura causing a tension pneumo

325
Q

NNT

A

NNT=1/ARR

326
Q

ARR

A

control rate - treatment rate

327
Q

RR

A

treatment rate / control rate

328
Q

RRR (relative risk reduction)

A

ARR/control rate

329
Q

Acyclovir

A

anti-viral

nucleotide analog that is incorederated into newly replicating viral DNA

330
Q

Chocolate agar

A

H. Influenzae

331
Q

Thayer-martin agar

A

N. Gonorrhoeae

N. Meningitidis

332
Q

Bordet-gengou agar

A

B. pertussis

333
Q

Tellurite agar

A

C. diptheriae

334
Q

Lowenstein-Jensen agar

A

M. Tuberculosis

335
Q

Eaton agor

A

M. pneumonae

336
Q

MacConky agar

A

Lactose fermenting enterics

Fermenting colonies turn pink

337
Q

eosin-methylene blue agar

A

e coli

338
Q

sabouraud agar

A

fungi

339
Q

vein that supplies the fundus of the stomach

A

short gastric veins that drain into the splenic vein

340
Q

Neuroenducrine markers

A

NCAM, enolase, chromogranin, synaptophysin

341
Q

IP3 activates

A

protein kinase C after activated by PLC

342
Q

layers that you have to go through to do a cricothyrotomy

A
  1. skin
  2. superficial cervcal facia
  3. investing and pretrachial layers of the deep cervical facia
  4. Cricothyroid membrane
343
Q

cocaine withdrawl symptoms

A

Increased appetite, hypersomnia, intense psychomotor retardation, severe depression

344
Q

NK-1 receptor antagonists

A

aprepitant, fosaprepitant

used for chemo induced emisis

345
Q

area posteremia

A

chemoreceptor trigger zone that communicates with nucleus tractus solitarus

346
Q

how does digoxin slow the ventricular rate during a-fib RVR

A

enhancing vagal tone which leads to decreased AV nodal conduction

347
Q

early sign of doxyrubacin accociated cardiomyopathy

A

swelling of the sarcoplasmic reticulem

348
Q

common peronial nerve damage

A

unable to every foot, numbness over orsum of foot and lateral shin

most commonly damaged nerve

349
Q

holosystolic murmur over left sternal boarder that increases with hand grip exersice

A

VSD

hand grip exercise increases after load

350
Q

cell type that predominates in sarcoidosis

A

CD4+ T-cells

351
Q

mutation in familial hypocalciuric hypercalcemia

A

Calcium sensing receptors with are transmembrane g-protein coupled receptors that help to moniter PTH release

AD

352
Q

entacapone

A

COMT used in parkensons that inhibits peripheral degradation of levadopa thereby increasing the quantity of levadopa entering the brain

353
Q

lymph drainage from the scrotum

A

superficial inguinal nodes

Swollen with a superficial scrotal abcess

**Pay attention to the word superficial

354
Q

difference between mono and mono-like syndrome

A

Infectious mono is caused by EBV and have serum heterophile antibodies that agglutinate with horse serum

with out the agglutination it is most likely CMV

355
Q

treatment of infertility in women with PCOS

A

Estrogen receptor modulation with clomiphene

356
Q

antiseptic properties of alcohols (isopropanol and ethanol)

A

disruption of cell membranes

denaturation of proteins

357
Q

chlorhexidine

A

disruption of cell membranes

coagulation of cytoplasm

358
Q

iodine

A

halogenation of proteins and nucleic scids

359
Q

gp 120 in hiv

A

attachemt to target cell by binding CD4 receptor

cleaved from gp160 which is glycosolated before hand

360
Q

pharmocologic intervention for restless leg syndrome

A

dopamine agonists

361
Q

transient side effects of ACE-I

A

Hyperkalemia and increased creatnine

362
Q

hypoketoic hypoglycemia

A

defect in beta fally acid oxidation

nost commonly an acyl- CoA dehydroginase deficency

363
Q

mood reactivity, unstable relationships, chronic feelings of emtiness, inappropriate intense angre, stress related paranoia

A

borderline personality disorder

364
Q

perineal body

A

tendinous center point of the perineum that seperates urogenital and anal triangles

cut in an appeasiotomy

365
Q

compisition of MHC-1

A

heavy chain and B2- micorhlobulin

366
Q

MHC 2 compisition

A

Alpha and beta polypeptide chain

367
Q

what is the potentancy of an inhailed analgesic determined by?

A

minimal alveolar concentration

percentage of anesthetic in inspired gas that renders 50% of patients unresponsive to painful stimuli

368
Q

how does the PSNS slow the heart rate

A

prolonging the AV node refractory period

369
Q

Where is the leasion is decerebrate posturing

A

at the level of the pons

370
Q

damage to the cerebral hemispheres

A

decorticate (flexor) posturing

371
Q

causes of polyhydramniose

A

GI obstruction, anencephaly

372
Q

rhinovirus

A

SS + sense RNA that is naked

Does not require additional machienery to replicate

373
Q

edema factor in B. anthracis is similar to a toxin from??

A

B pertussis

both increase cAMP

374
Q

signs and symptoms of vit-A over use

A

alopecia, dry skin, HLD, hepatospleno megaly, and pseudotumorcerebrae which can present with papilledema

375
Q

sickle cell inheratance

A

AR

376
Q

next test to order after Alk phos is elevated

A

gamma-glutamyl transpeptidase (GGTP)

tells you in the problem is in the liver or the bone

377
Q

what is increased in hereditary spherocytosis

A

mean corpuscular hemoglobin concentration

378
Q

what do integrins bind to

A

fibronectins

fibronectins are large glycoproteins produced by fibroblasts and some epithelial cells

binds to integrins, matrix collagen, and glycosaminoglycans

379
Q

treatment for diptheria

A
  1. diptheria antitoxin (passive immunization)
  2. penicillin or erythromycin
  3. DPT vacciene
380
Q

ehlers-danlos syndrome possible cause and presentation

A

easy bruising, thin skin

pro-collagen peptidase deficency ==> unable to cleave the N-terminal peptide

issue with extracellular protein cleavage

characterized by disulfigde rich globular domanes

381
Q

esophagus on CT

A

collapsed tube located between the trachea and the vertebral bodies on the L side

382
Q

H. influenza

A

requires hematin and Nad+ to grow on blood agar

depends on a polysaccharide capsule

undervaccinated child

recent ototis media

383
Q

POM-C

A

ACTH
MSH
Beta-endorphan (binds to mu and delta receptors)

384
Q

treatment for PDH deficency

A

ketogenic diet

leucine and lysine and exclusively ketogenic and will not aggravate lactic acidosis

385
Q

AA that are ketogenic and glucogenic

A

phenylalanine, isoleucine, tryptophan

386
Q

non-painful original genital ulcers

progresses to several draining ulcers with lymphadenopathy with cytoplasmic inclusion bodies

A

lymphogranuloma venereum caused by chlamydia trachomatis

serotype L1 - L3

387
Q

hydrocephalus, intracranial calcifications, and chorioretitinitis (white-yellow)

A

triad on intra-uterine infection of toxoplasmosis (cat-box disease)

388
Q

short acting insulins

A

lispro, aspart, glulisine

altered c-terminal of b chain allows for more rapid absorption

389
Q

labs when T3 is given

A

decrease TSH, T4, and rT3

390
Q

flumazenia

A

used for benzodiazapine overdose

391
Q

antidote for seritonin syndrome

A

cyproheptadine

5HT receptor agonist

392
Q

donepezil

A

cholenesterase inhibiter used in alheimerz dementia

3 ways to treat:

  1. inhanced cholinergic neurotransmission
  2. neuroprotection via anti-ocidents like Vit-E
  3. NMDA receptor antagonism
393
Q

vincristine

A

used to treat non-hodgkin lymphoma

interferes with microtubule formation in nerve axons causing numbness and tingling in the fingers

394
Q

bilateral numbness in fingers 1-3 in a dialysis patient

A

deposition of Beta-2-microglobulin (dialysis related amyloidosis) in the carpal tunnel

395
Q

enzymatic deficency in heriditary gentitaional diabetes

A

glucokinase

this is a kind of maturity onset diabetes of the young
mild, nonprogressive hyperglycemia that worsens with pregnancy induced insulin resistance

396
Q

WNV

A

SS RNA + sense
mosquito vector
encephalitis

397
Q

Dihydrobiopterin reductase

A

needed to make both Tyrosine from phenylalanine and DOPA from tyrosine

elevated prolactin after restriction of phenylalanine

398
Q

symptoms of the electrolyte abnormalities caused by hyperaldosteroneism

A

Hypokalemic alkalosis causes muscle weakness and paresthesias

399
Q

intercranial hemmorhage in new born with CF

A

Vit K deficency

400
Q

skeletal muscle resistance to verapimal

A

no dependance on extracellular calcuium

401
Q

what accounts for the green color of sputum with an S. pneumo infection

A

myeloperoxidase from neutrophils

402
Q

how long does it take for myocyted to lose contractility after ischemia

A

60 seconds

ATP [] is still normal but it is used rapidly withing the cell and lactate builds up

403
Q

gene mutation in neurophysins

A

carrier protein in the pituitary

mutations could cause diabetes m

404
Q

what provides the major proliferative stimuli for cellular componants of atherosclerotic plaques

A

platelets

PDGF and TGF-beta

405
Q

mechanism and use of sumatriptan and other triptans

A

5-HT-1B/5-HT-1D agonists

Block post synaptic seritonin action

seritonin is a vasoactive amine

406
Q

cold agglutinans in the presence of a persistant cough and pulmonary infiltrate

A

mycoplasma pneumoniae

responsiable for the transient anemia seen with this infection

407
Q

Nicotinic cholenergic receptors

A

these are ion channels with 5 subunits with 2 Ach binding sites that will open if both binding sites are filled

408
Q

what is aqueous humor produced by and what decreases its production

A

ciliary epithelial cells

Timolol, betaxolol

carbonic anhydrase inhibitors

alpha agonists: brimonidine

409
Q

where can a surgeon gain access to the great saphanous vein

A

medial leg or just inferolateral to the pubic tubricle

410
Q

aortic arches

A

1st: portion of the maxillary artery
2nd: stapedial artery
third: common and proximal internal carotid arteries
fourth: true aortic arch and subclavian arteries
fifth: obliterated
sixth: pulmonary ateries and ductus arteriosus

411
Q

pharengial arches

A

1- trigeminal nerve, mandible, malleus

2- facial nerve, muscles of facial expression and eare, hyoid associated muscles

3-glossopharengial- hyoid bone and stylopharengeas muscle

4- superior larengial branch of the vagus nerve muscles of pharynx and soft pallet

6- recurrant lyerengial branches of the vagus nerve, muscles of the larynx

412
Q

retinal hemmorhages and a full fontenal

A

suspect shaken baby syndrome

413
Q

zellwiger syndrome

A

peroxisomal disease with issues breaking down VLCFA

hypotonia and seziures, hepatomegaly, mental retardation, early death

refsum disease is a problem with alpha oxidation of VLCFA

414
Q

Macular sparing

A

occipital leasion

415
Q

catalase + organisms

A 
staph A 
Burkholderia cepacia
Serratia marcescens 
nocardia
aspergillus

affect people with CGD

416
Q

perfusion defect not matched by ventilation defect

A

PE caused by DVT

417
Q

where do anal fissures usually occur

A

posterior midline distal to the dentate line

tearing pain
blood on tissue paper

418
Q

factor V lyden

A

mutated factor V cannot bind protein C and thus causes a HYPERcaoguable state

419
Q

pseudogout

A

calcium pyrophosphate deposition disease

rhomboid shaped pyrophosphate crystals

knee is often the first joint affected

420
Q

sebacious glands

A

holocrine- cell lysis releases entire contents of the cytoplasm

inflammatory acne

421
Q

surface protein on bacteria

A

confers virulance to human cells

422
Q

baclofen

A

agonist of the GABA-B receptor and used for muscle relaxation

423
Q

haptaglobin

A

binds to free hemoglobin especially in the case of hemolytic anemia

424
Q

what takes over in the case of fructokinase deficency

A

Hexokinase

fructose ==> f6p

425
Q

most common cause of retinitis in HIV patients

A

CMV

HIV patients with CD4+ counts

426
Q

cystic posterior neck mass (cystic hygroma), lymphedema, deminished pulses

A

turners syndrome

427
Q

posatively skewed

A

Mean>median>mode

oppisite for negative skew

428
Q

what detects changes in CO2

A

carotid body and aortic chemo receptors

stimulated by hypoxemia

429
Q

What muscles need to be strengthened in women with stress urinary incontinance

A

levator ani to decrease urethral hypermobility

430
Q

pertussus

A

gram - coccobacillus

adheasions and toxins

adenylate cyclase toxin and pertussis toxin

100 day cough

431
Q

niacin

A

increases HDL, lowers LDL

Flushing is mediated by prostaglandins

can decrease these side effects with aspriin

432
Q

renal stones in the setting of a pituitary tumer

A

sign of hypercalcemia caused by hyperparathyroid

pancreas should also be screened

433
Q

lactase deficency causes a decrease in….

A

stool pH

434
Q

kind of mutation in sickle cell and hemaglobin C

A

Missense

glutamate is replaced for valiene or leucine

435
Q

nonnucelotide reverse transcriptase inhibitors

A

nevirapine and efavirenz

life threatening hepatic failure is a side effect

do not require activation via intracellular phosphorolation

436
Q

what do you want to be sure to ligate when removing an ovary?

A

the suspensary ligament of the ovary which contains the ovarian artery, veins, lymphatics, and nerves

437
Q

stop codons

A

UAA, UAG, UGA

recognised by relasing factor 1

438
Q

infant with oral thrush, interstitial PNA, and lymphopenia within the first year of life

A

suspect vertical transmission of HIV-1 especially if the mother is an IV drug user and did not take ART during her pregnancy

439
Q

Polyarteritis nodosa

A

renal and viseral organs affected==> it spares the pulmonary arteries

immune complex mediated

transmural inflammation with fibranoid necrosis

treat with corticosteroids and cyclophosphomide

440
Q

physiostigmine

A

acetocholenesterase inhibitor that penetratates the CNS

Neostigmine==> NO CNA penetration

441
Q

how long do symptos need to be around for someone to be diagnosed with major depressive disorder

A

> 2 weeks

go thorugh SIGECAPS

442
Q

stroke in the setting of DVT

A

Atrial septal defect

split S2 that does not change with inspiration

443
Q

loss of sensation associated with decreased petellar reflexes

A

Femoral nerve compression

medial thigh and leg

444
Q

caloric equivilants

A

protein==> 4 cal /g

fat ==> 9 cal/g

ethanol 7 cal/g

445
Q

muscuranic + nicotinic blockade

A

botulism

symptoms improve with multiple stimulations

446
Q

what medication can increase hypoglycemic unawareness in patients with diabetes

A

non-selective B-blockers like propanolol

447
Q

enzyme effected in xeroderma pigmentosum

A

Endonuclease

448
Q

most effective treatment for specific phobia

A

Behavioral therapy

think of people being afraid of elevators

449
Q

defective enzyme in maple syurpe urine disease

A

alpha ketogluterate

thymine, lipolate, Co A, FAD, and NAD are cofactors

some poeple will improve with thymine infusion

450
Q

head ache and sudden blindness in an older woman

A

temporal arteritis which is a giant cell/ large vessel arteritis

can present with polymalagia rheumatica (torso, shoulder, joint pain with fever and weight loss)

can occur in men
IL-6 is implicated so use tocilizumab to treat

451
Q

hand joints involved in rheumatoid arthritis

A

MCP, PIP

Spares the DIP joints which are effected by osteoarthritis

prolonged morning stiffness >30min often accompanied by systemic symptoms like fever and weight loss

452
Q

porcelin gallbladder

A

high risk of gall bladder cancer

caused by chronic cholecystitis

453
Q

bilateral angiomyolipomas

A

associated with tuberous sclerosis

autosomal dominant

they have brain hamartomas and ash-leaf skin patches, cardiac rhabdomyomas

454
Q

side effects of methotrexate

A

it effects rapidly growing cells so you get mouth ulcers, hepatotoxicity, and pulmonary fibroses

455
Q

what is contained in the hepatoduodneal ligament

A

portal vein, hepatic artery, common bile duct

if that is occluded and the patient is still bleeding it is most likely the IVC

456
Q

AV shunt affect on preload and after load

A

increase preload because they decrease resistance of flow

They also decrease total periferal resistance

457
Q

accuracy

A

gives a number close to the same value

458
Q

persicion

A

consistantly provides the same result

Reproducability of a test

**Reliability is the same as persicion

459
Q

rebound nasal congestion

A

stop the decongestant

460
Q

patient with BPH that with orthostatic hypotension

A

terazosin or doxyzosin alpha-1 blockade

**dont assume they are on other drugs

461
Q

recurrant nisseria infections

A

inability to make the membrane attack complex with complement

multiple episodes of menengitis and small vessel vasculitis (hands and feet)

462
Q

drug of choice for beta blocker overdose

A

glucagonincreases camp and thus increases calcium in cardiac myocytes

463
Q

what part of tRNA binds to amino acids

A

the 3’ end

the anti codon is on the opposite end and binds to mRNA

464
Q

meglitinides

A

Repaglinide and nateglinide

short acting glucose lowering medications

similar to sufonureas and act by binding to the ATP dependant K+ channel in the pancreatic beta cell membrane

465
Q

short term treatment for insomnia in an elderly patient

A

melatonin agonist like Ramelteon

for elderly patients you need to pay attention to the side effects like dizzyness and confusion

466
Q

what is seen on endometreal cutterage during an ectopic dregnancy

A

decidualized endometreum which you would see in someone iwth a normal pregnancy

467
Q

what causes type 1 diabetes

A

leukocytic infiltration of islet cells because if is an autoimmune disease

468
Q

lab findings in iron deficency anemia

A

low serum ferritin

Low MCV

High circulating transferrin

remember that iron defecincy anemia is a MICROCYTIC anemia

469
Q

imuune cell with which cell marker surrounds necrtizing granulomas in TB

A

CD14 (monocytes and macrophages)

470
Q

Type II pompe disease

A

acid alpla glucosidase deficency

  • normal glucose levels
  • severe cardiomegaly
  • glycogen accumulation in lysosomes

“pompe trashes the pump”

471
Q

Von gierke

A

Glucose-6phosphatase deficency

  • severe fasting hypoglycemia
  • increase glycogen in liver
  • increased blood lactate
  • increased uric acid
  • hepatomegaly
472
Q

cori disease

A

Debranching enzyme deficency

Milder form of von-girk with normal lactate levels

473
Q

mcardle disease

A

skeletal muscle glycogen phosphoralse deficency

-increased glycogen that cannot get broken down so they have painful muscle cramps, myoglobinuria, and arrythmia from electrolyte abnormality

474
Q

what step is effected in someone iwth GAPD deficency

A

from G6P ==> 6-phosphogluconate

which makes one NADPH which is needed to combat oxidative stress

part of the hexose monophosphate shunt

X linked ressesive disorder

475
Q

antibodies against PRP

A

immunity against H-influenza

polyribitol ribose phosphate

476
Q

people with alpha-1 anti tripsin deficency should avoid

A

smoking

they are missing A1AT which impairs elastin degradation by neutriphil products, os they are most likely to get emphasemia at a young age

477
Q

what should be used for post surgical urinary retention

A

a muscuranic agonist like Bethanechol

also used for post surgical ilius

478
Q

Most common lung cancer in non-smoking women with no occupational exposures

A

ademocarcinoma

it is often a peripheral leasion

479
Q

psyologic changes in lung mucosa in patients with CF

A

increased Na+ absorption

causes mucus to be dehydrated
the Na+ channel is usually inhibited by Cl- but sice the CFTR gene codes for the Cl- channel more Na+ is absorbed

480
Q

how does prostate cancer metastisise

A

the prostatic venous plexus

**note that the lymphatic system rarely aids in metastisis to the bone

481
Q

actinomycosis

A

anaerobic gram + bacteria

Treat with panicillin if it causes systemic disease

look like big clumps of purple with sulfer granules
patients with poor dentition because it is a part of the normal flora

filimentous branching patterns

482
Q

first line treatment for absent sezures and tonic clonic seziures

A

Valproate

483
Q

penicillin is strcuturally similar to what

A

D-ala-D-ala

484
Q

drug to use for pulmonary hypertension

A

Bosentan

endothelin-receptor antagonist that blocks the vasoconstrictive effects od ando thilin

485
Q

mechanism of OCPs in preventing pregnancy

A

they maintain low serum gonadotrophen levels

while estrogen and progesterone remain high LH and FSH are supressed

486
Q

what is the normal intrapleural pressure

A

-5

drops to - 7.5 upon inhilation

487
Q

what physiologic process contributes to abcess formation

A

lysosomal content release by macrophages

488
Q

true vocal folds are covered by

A

straified squamous epithelium

489
Q

what is the primary component of pulmonary surfactant

A

phosphatidylglycerocholine

phosphatidylcholine ==> also known as lechtin

490
Q

alternative medication to asprin in the setting of angina pectoris

A

clopidogrel

491
Q

what bonds account for elastins elastic properties

A

interchain cross linking invilving lysine

these are called desmosine cross links

this happens because of a large pulse pressure

492
Q

head bobbing and bounding femoral pulses

A

aortic regurge

493
Q

decreased absorption of cystiene, ornithine, lysine, arginine (cola)

A

Cystinuria
increased risk for kidney stones

sodium cyanide nitroprusside test +

494
Q

where is Ach decreased in Alzheimers

A

the nucleus basalis or the basal nucleus of meynert whitch participates in memory and cognition

located at the base of the forebrain and projects to the neocortex

the hippocampus is also involved in memory

495
Q

what structure can be obstructed by the SMA

A

the transverse portion of the duodenum

can happen in any condition where the patient has decreased mesentaric fat

496
Q

ehlers danlos

A

can be caused by a procolligen peptidase deficency in which patients are naple to cleave the N-terminus of collagen

497
Q

how do most envoloped viruses aquire their envolope

A

by budding off of the host cell plasma membraane

HSV uses the nuclear membrane

498
Q

treatment for and presentation of enterobiasis

A

perianal itching

use albendazole first like

pyrantel pamoate can be used in pregnant women

499
Q

when e-coli is plated with lactose why are bothe B-galactosidase and galactoside ppermiase expressed/prodouced

A

there is one mRNA coding for both enzymes

500
Q

notching of the ribs on x-ray

A

coarctation of the aorta

501
Q

deficency in CGD

A

NADPH oxidase

diagnosis made by DHR flow testing and NBT testing

502
Q

what does disulferam inhibit

A

aldehyde dehydroginase

503
Q

triad of mcCune albright syndrome

A

Mutation during embryogenisis of the GNAS gene ==> gain of function mutation in alpha subunit of G-proteins leading to multiple abnormalities

Cafe-au-lait spots

endocrine abnormalities (precousious puberity, hyperthyroid)

Fibrous dysplasia- abnormal proliferation of fibroblast like cells

504
Q

dermititis induced by poisen ivy (urishol)

A

delayed type hyper sensativity that is elicited by T-cells

T-cells are associated with the associated damage

505
Q

what must be known to amplify a DNA sequance of intrest

A

the DNA sequance of the segments flanking the segment of intrest

506
Q

drooping of the shoulder
problems reaching over head
impaired winging of the scapula

A

Trapizius

Nerve T12

507
Q

where is RNA made

A

in the nucleolus

508
Q

glossopharengial nerve sensory innervation

A

tympanic membranee, eustation tube, posterior tound, general tonolar lining (gag affarent portion), carotid body, carotid sinus

509
Q

polymyositis

A

proximal muscle weakness and myanagias with insidious onsey

ANA and anti-jo (Histidyl tRNA synthetase) antibodies are likely present

elevaled CK

endomysieal monocytic infiltrate on histology

interstitial lung disease and myocardidis are other complications

can be a paraneoplastic manifestion of adenocarcinoma

510
Q

HIV asociated dementia

A

Will see microglial nodules on histology

progressive memory loss with CD4+ counts

511
Q

mechanism of resistance to aminoglycosides

A

acetylation on the drug

512
Q

oppositional defiant disorder

A

intentionally annoys others, blames others for own mistakes, easily annoyed

differentiate from conduct disorder: harms others or animals

513
Q

best immidiate treatment for patient that is hypoglycemic and unconsious

A

IM glucagon

514
Q

HER2/neu oncogene

A

185 kD transmembrane protein that have tyrosine kinase activity and accelerated cell proliferation when activated

515
Q

histology of AAA and cause of AAA

A

chronic transmural inflammation

516
Q

Ankalosing spondolitis

A

-low back pain

  • limited chest expansion
  • enthesitis (inflammation of the site of insertion of a tendon to the bone

-acute anterior uveitis

517
Q

drugs that impair lithium excretion

A

HCTZ (mostly, ACEI , NSAIDS, decreased GFR

lithium tox: nausea, vomiting, diarrhea, confusion, ataxia, tremmers, faciculations

518
Q

final mutation to get to adenocarcinoma of the colon

A

APC==> K-RAS==> p53

519
Q

what best explains metoprlol’s effect on BP

A

decreased level of circulating renin

they decrease renin release from the kidney

520
Q

where are enhancers located on genes

A

Variable locations

can be upstream, downstream, close, or far

521
Q

a hyperpigmented leasion on or below the breast that becomes sore with menses and increases in size with puberty

A

Extra nipple

caused by the failed involution of the mammory ridge

522
Q

what is responsiable for the skin reaction to a bee sting

A

histamine

523
Q

what does the superior thyroid artery course with

A

superior thyroid artery
superiorthyroid vein
external branch of the superior lyrengial nerve which iinnervated the crycothyroid

524
Q

what activates tripsin

A

enteropeptidase

525
Q

facial swelling after being extubated

A

think parotitis caused by staph aureus

measure amylase

526
Q

what does 99mmTc-pertechnetate detect

A

the presence of gastric mucosa in the case of a meckles diverticulum

failure of obliteration of the omphalomesenteric duct

527
Q

anti fungal that targets the cell wall

A

caspofungin

blocks glucan synthasis

528
Q

deficency in what vitamin causes complications with the measels virus

A

Vit A

can prevent ocular complication and decrease recovery time

529
Q

common reperfusion arrythmia

A

accelerated idioventricular

530
Q

mifepristone

A

progesterone antagonist

531
Q

where do P-bodies interact with mRNA

A

cytoplasm only

532
Q

what are women with prolactinomas at risk for

A

loss of bone mass because of decreased estrogen

533
Q

what kind of genetic mutation in CF

A

frame shift

534
Q

what does raltegravir do

A

impairs mRNA transcription

it is an integrase inhibitor

535
Q

what differentiates schizophrenia from schizo effective disorder

A

mania is not associated with schizophrenia but it is associated with schizo-effective disorder

with schizo-affective disorder the patient must have hallucinations without a mood symptom but it can be associated with mania

536
Q

ulcerated anal mass in the setting of HIV

A

squamous cell carcinoma of the anus caused by HPV

can precent with itching and bleeding

537
Q

fenoldopam

A

a dopamine (acts only at D1) agonist used for vasodilation and naturesis

538
Q

side effects of atazanavir (protease inhibitor used in HIV

A

Lipodystrophy
Hyperglycemia
CYP 450 inhibitor

539
Q

what is a PFO

A

incomplete fusion fo atrial septum primum and secundum

540
Q

most important factor of e-coli that allows them to cause UTIs?

A

Fimbrial antigen

541
Q

pattern of oxygen labs in chronic blood loss

A

PaO2==> normal

SaO2==> normal

total oxygen content==> decreased

542
Q

what in packed RBCs can cause hypocalcemia

A

citrate

this happens when there is a big trauma and you need to transfuse a lot of blood

543
Q

patient that doesn’t like to socialize for fear of critisism but is very respectful of others

A

avoident personality

antisocical people have a disregaurd for other peoples emotions and often become involved in criminal activity

544
Q

sheets of primitive cells with many mititic figures in the cerebellum of a child

A

medulloblastoma

must use a microscope to differentiate from pilocyticastrocytoma

545
Q

fibrous deposits around the tricuspid and pulmonary valves with pulmonary valve stenosis

A

think carcinoid syndrome

measure a urinary 5-hyroxyindoleactic acid

546
Q

order of airway resistance

A

Medium airways (because of turbulent flow) > trachea> bronchials>terminal bronchioles

**don’t forget about turbulant frow

547
Q

why is primaquine added to chloroquine for maleria treatment

A

to completely erredicate malaria and prevent relapse of the virus

548
Q

congenital cateracts, deafness, and pulmonary stenosis with PDA

A

congenital rubella which can be prevented with a live attenuated vacciene before conception

549
Q

Percardidis symptoms 3-4 days after an MI

A

Inflammation of the pericardium overlying the necrotic segment of myocardium

dresselers syndrome takes longer

550
Q

what disorders is gout associated with

A

lech nehyn

myleoproliferative disorders like PCV

551
Q

first line treatment for sustained tonic clonic seziures

A

Benzodiazapine

IV Lorazapam

causes enhanced postsynaptic Cl- influx

552
Q

most effective action of methimazole

A

blocks thyroid peroxidase, inhibiting the oxidation of iodide and the organification of iodine. This really helps patients symptoms

it also blocks 5,-deiodinase which decreased peripheral conversion of T4 to T3

553
Q

what metabolized a lot of toxins

A

cyp450 microsomal monooxygenease

increased about of these can predispose a person to cancer caused by toxins

554
Q

thorascic outlet syndrome

A

compression of the lower trunk of the bracheal plexus and subclavial vessels commonly because of the anterior and middle scalene muscles

555
Q

treatment that causes cells to disintegrate when exposed to a hypotonic solution

A

cell wall active agents

556
Q

virulance factor that allows e-coli to cause menengitis

A

K- capsular antigen

it must have this to cause menengitis

557
Q

bacillary angiomatosis

A

bartonella henselae in immunocompromised patients

also causes cat scratch fever

558
Q

what do dextrans adhere to?

A

Fibrin

fibrin-platelet- aggregrates are found at sites of endothelial trauma

559
Q

C. perfrengies toxin

A

lecithinase

splitting of phospholipid molecules

560
Q

cytoscopy

A

procedure involving the genitourinary tract that could expose you to enterococci

561
Q

most common cause of menengitis in adults

A

strep pneumo

562
Q

The only SS DNA virus

A

parvovirus

can cause an a plastic crisis in patients with sickle cel l

563
Q

no cardia

A

weakly gram + branching rod that can cause brain abcessed (ring enhancing leasion)

treat with TMP-SMX

564
Q

how dose N. Meningididis get into the CSF

A

pharynx ==> blood ==> choroid plexus ==> meninges

565
Q

what causes anemia in M. pneumonia infection

A

cold agglutinans

the anemia resolves after the infection because the immune response fades and the cold agglutinanes go away

566
Q

neurologic symptms, renal symptoms, fever, thrombocytopenia, increases bleeding time, normal pt / ptt

A

thrombotic thrombocytopenic purpura

ADAMTS13 (vWF metallo protease deficency)
increased aggrigation and throbosis

kinda looks like a prolonged veersion of DIC

treat with plasmaferesis and steroids

567
Q

classical galactosemia

A

Autosomal recessive

568
Q

cyclosporin and tacrolimus

A

inhibit calcinurin

by inhibiting calcinurin T cell proliferation is supressed

these are immuno suppressants used after transplant

569
Q

amyloid confined to the atria

A

consists of misfolded natriuretic peptide

occurs in the elderly

570
Q

schizotypal personality

A

eccentric, odd thoughts, perceptions and behavior

571
Q

ventral pancreatic primortium guves rise to what

A

the main pancreatic duct

572
Q

regular insulin

A

starts working in 30 min

peaks in 2-4 hours

lasts 5-8 hours

use to long term managment of type 1 diabetes

573
Q

bacterial DNA pol III

A

removes improper base pair nucleotide DURING replication

574
Q

aids in internal rotation

innervated by the thoraco dorsal nerve

A

latissimus dorsi

575
Q

NF-KB

A

down requlated in chrones

involved in cytokine production

it is proiinflammatory

576
Q

what is required to send someone to hospice

A

Patient has a prognosis of 6 months or less

577
Q

umbilical hernias are due to what?

A

incomplete closure of the umbilical ring

578
Q

matching studies help eleminate what

A

confounding because you are makeing sure both groups have a similar distribution

579
Q

how do you treat essential tremor

A

propanolol

follows an autosomal dominant inheratance pattern

580
Q

sporotrichosis

A

Fungus that gardenders get because they get pricked by a thorn

Painless raised granulomas on the prms

581
Q

RPF equation

A

RBF * (1-hematocrit)

need for filtration fraction

FF=GFR/RPF

582
Q

patients that undergo a total gastrectomy will need to be supplimented with what

A

water soluble vitamines like B12

583
Q

sirolimus

A

inhibits mTOR which leads to interruption of IL-2 signal transduction

U world journal (4 decks)

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